In August of 1997 the Food and Drug Administration (FDA) relaxed the rules governing broadcast advertising of prescription pharmaceutical products. Shortly thereafter, expenditures on direct to consumer advertising (DTCA) for prescription pharmaceuticals soared. This has lead to a great deal of debate in the medical profession and among health care insurers and managed care organizations. We propose to study one possible effect of DTCA - whether exposure to DTCA can improve patient adherence to prescribe pharmaceutical therapy (statins) for the treatment of hyperlipidemia. Adherence to therapy is known to be a barrier to effective care for many chronic diseases. Treatment with prescription statins has become a principal modality for managing hyperlipidemia. Several of the statins are among the most heavily advertised pharmaceuticals since 1997. We hypothesize that patients who are in areas where these drugs are heavily advertised will have better adherence to their prescription therapy than patients who live in areas where these drugs are not advertised, and as a consequence will have better outcomes. This proposal has four principle aims: 1) determine the degree to which DTCA affects physician patient populations; 2) determine the impact of DTCA on the likelihood that a patient is prescribed a lipid-lowering drug; 3) determine the impact of DTCA on adherence to therapy, given that a patient has a prescription; and 4) Determine the impact of DTCA on the effectiveness of prescription statin therapy. This study will utilize a unique research data base which combines detailed clinical information (from an extract of the electronic medical records of 65 geographically dispersed primary care practices) with detailed advertising data (brand, month, and media-market specific). A series of econometric models will be estimated to determine the adherence and health effects of DTCA. [unreadable] [unreadable]